Kidney stone disease in children is always a therapeutic challenge. It is a multifactorial condition and it should be approached, diagnosed and treated as such. One of the biggest challenges is kidney stones located in the lower renal calyx. There are currently three main surgical techniques to treat this condition: ESWL—Extracorporeal Shock Wave Lithotripsy, RIRS—Retrograde IntraRenal Surgery, and PCNL—PerCutaneous Nephro-Lithotripsy. In pediatric population, the most frequently used method is ESWL, and in the event of failure, endoscopic procedures are the second-best choice. In this article, a sample of 53 children admitted to a tertiary medical center was examined. Thirty-eight of those children underwent flexible URS, while the remaining 15—micro PCNL. The average size of the deposit in the former group was 12.2 mm, against 13.5 mm in the latter. The full Stone Free Rate (SFR) was achieved in RIRS at 84.21 and 86.7% in percutaneous nephrolithotripsy. Flexible ureterorenoscopy and MicroPERC are two comparably effective methods for treating lower calyx stones of any size. However, according to our data, flexible ureterorenoscopy carries a lower risk of complications and inpatient care (with the mean of 3 days). The learning curve for these procedures in pediatric urology is long and relies on a limited number of patients. The number of pediatric patients qualifying for these procedures is restricted also due to the high efficacy of extracorporeal shock wave lithotripsy in pediatric population. Radiation exposure is an important factor in every endoscopy procedure and should never exceed the limits set in the ALARA protocol. ESWL remains to this day the treatment of choice for stone disease in children and can be performed under ultrasound control. For many parents, it is a first-choice treatment preference for their child due to its greater apparent safety, although data on this remains insufficient. Prospective, randomized, multicenter trials are definitely needed.

Purpose The purpose of this paper is to present the methodology for manufacturing of aircraft transmission gears using incremental method of rapid prototyping (RP) – direct metal laser sintering (DMLS). The production of prototypes from metallic powders using described system allows the execution of final elements of complex structures with additional economic impacts. Design/methodology/approach The paper describes the use of selective laser sintering method (DMLS) by EOS Company. Whole chain of production of prototype is presented with the addition of geometric accuracy measurements by blue light laser device. Findings Presented in the research analysis of SLS/SLM technologies as rapid manufacturing systems shows that they can be applied in the production of prototypes used in the manufacturing process of gears for propulsion systems in aviation industry. Also, very important is the geometrical accuracy of gear prototypes produced by incremental methods. It determines subsequent treatment steps for aircraft propulsion system gears. Practical Implications The use of RP techniques as an alternative for conventionally used manufacturing method has mainly an economic impact related to the cost of time-consuming process and amount of defected elements appearing in serial production. Originality/value This paper presents possibility to use RP – DMLS system – for propulsion elements of aircraft structure. This research is original because of the complex description of the whole chain of manufacturing process. Additionally, geometrical accuracy measurement methodology by blue light presented with the RP method of manufacturing gives the research a unique characteristic.

Purpose -The purpose of this paper is to present the use of a CAD system for the analysis of meshing of spiral bevel gears. Design/methodology/approach -The TCA computer programs are based on a purely mathematical model and require to get the numerical solution of a set of nonlinear equations. There are situations that the programs fail to obtain the proper solution. In such cases, geometrical gear models defined in CAD environment prove to be a good choice. This paper describes a tool for analyzing tooth contact and transmission errors of spiral bevel gear sets with tooth flanks represented as CAD free-form surfaces. Findings -A new method has been proposed to keep those surfaces in continuous contact in the whole range of meshing of a mating tooth pair. During meshing, the points of contact as well as the corresponding angles of rotation of both the pinion and the ring gear are recorded. Thus, the tooth contact path as well as the motion transmission error graph is determined. Then, the contact pattern that is formed by a set of instantaneous contact ellipses is designated. Practical implications -The TCA results are essential for the assessment of the gear set quality in the early stages of the process of its development. Originality/value -All the results presented in graphical form are very illustrative and easy to interpret.

Wpłynęło w kwietniu, zaakceptowano w październiku 2021 r.Streszczenie: Chociaż tematyka oparzeń wydaje się być stosunkowo dobrze opracowana w piśmiennictwie, nadal istnieje potrzeba określenia związku patomechanizmu urazów termicznych z kluczową kwestią zakażeń w ich obrębie. Niezmiernie istotna w przypadku zakażeń ran oparzeniowych jest diagnostyka mikrobiologiczna. Prawidłowe pobranie materiału klinicznego i wykonanie badań mikrobiologicznych pozwala na ustalenie czynnika etiologicznego zakażenia i dobranie antybiotykoterapii celowanej. Jest to szczególnie istotne w dobie narastania oporności drobnoustrojów na antybiotyki i częstego izolowania szczepów wieloantybiotykoopornych. Oparzenie bowiem, zwłaszcza rozległe, stanowi unikalne środowisko, które -wraz z nieprzemyślaną, bądź niecelowaną terapią -determinuje u drobnoustrojów nabywanie oporności na antybiotyki. Fizjologiczna obrona organizmu przed urazem prowadzi do sytuacji, kiedy w ranie oparzeniowej środki przeciwdrobnoustrojowe mogą nie osiągać MIC/MBC, co drastycznie zmniejsza szanse powodzenia terapeutycznego.

Urolithiasis can affect all children even preschool ones. Diagnostic difficulties in the youngest children are due to the problems in locating pain and determining its character and severity. In keeping with the ALARA (As Low As Reasonably Achievable) protocol, the number of imaging tests possible to perform is very limited. Ultrasound is the first line exam of choice. After diagnosis of the presence of a stone, ESWL (Extracorporeal Shock Wave Lithotrypsy) should always be considered and offered to parents due to its high effectiveness and minimal invasiveness. If ESWL is contraindicated or not well-accepted by parents, authors suggest another minimal invasive approach: URS-L (Uretherorenoscopy–Lithotrypsy). Our study clinically analyzes 87 children, which were treated between 2009 and 2017 using the URS-L procedure. URS-L treatments were performed using Lithoclast until 2009, and after that time, using the holmium laser Ho:YAG. The overall effectiveness of treatments was 93.3%. There was no failure in the access to the stones. A macroscopic hematuria (Clavien-Dindo I grade) was observed through the second post-operative day in 9.2% of treated patients. No urosepsis was observed. Full metabolic evaluation was performed on all patients. Children remained under constant urological and nephrological observation. A recurrence of urolithiasis was observed in 35.6% of the cases. Treating ureteral lithiasis in young infants remains a big challenge. Our series shows that modern minimal invasive techniques used by very experienced pediatric urologists in high volume centers gives excellent results. In most cases, surgery should no longer need to be an option.